Healthcare Provider Details

I. General information

NPI: 1841643723
Provider Name (Legal Business Name): MS. CAROLINE MASS
Entity Type: Individual
Gender: Female
Sole Proprietor: Y

II. Dates (important events)

Enumeration Date: 07/15/2016
Last Update Date: 04/07/2021
Certification Date: 04/07/2021
Deactivation Date:
Reactivation Date:

III. Provider practice location address

5007 CLAREMONT WAY
EVERETT WA
98203
US

IV. Provider business mailing address

PO BOX 34703
SEATTLE WA
98124-4206
US

V. Phone/Fax

Practice location:
  • Phone: 425-609-5505
  • Fax: 425-609-5506
Mailing address:
  • Phone: 206-764-0502
  • Fax: 206-764-0516

VI. Provider taxonomy

Scope of Practice (Provider specialty)

# 1
Primary TaxonomyY
Taxonomy Code1041C0700X
TaxonomyClinical Social Worker
License NumberSC 60244155
License Number StateWA

VIII. Authorized Official

Name:
Title or Position:
Credential:
Phone: